Fibromyalgia Drug Shows Promise in Treating IBS Pain
The medication could ease stomach pain for people with irritable bowel syndrome who aren't helped by current treatment options.
According to a small, preliminary study, a drug that's typically prescribed for fibromyalgia might also relieve pain related to irritable bowel syndrome (IBS)—the common GI disorder estimated to affect as many as 15% of adults. There's not enough evidence to recommend pregabalin (sold under the brand name Lyrica) to IBS patients yet, says the lead investigator, but she hopes her research will prompt further studies on the topic.
There is considerable overlap when it comes to fibromyalgia and IBS, says Yuri Saito-Loftus, MD, a gastroenterologist at the Mayo Clinic. Many patients experience both conditions together, and both involve pain of some sort.
Previous studies, mostly in animals, have suggested that pregabalin—which is also used to treat seizure disorders and diabetic nerve pain—could decrease visceral hypersensitivity, a sensation of pain within the internal organs that’s common in bowel disorders. So Dr. Saito-Loftus asked Pfizer, the drug’s parent company, to fund a small study to determine whether it may help people with IBS.
“Treatment options for managing abdominal pain—particularly moderate to severe pain—are limited to antispasmodics and neuromodulators such as tricyclic antidepressants,” Dr. Saito-Loftus told Health. “But if patients don't respond to those agents, there were few proven alternatives.”
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For the study, Dr. Saito-Loftus and her colleagues recruited 85 people with IBS, ages 18 to 70, all of whom reported high levels of abdominal pain. The participants took either pregabalin or a placebo for 12 weeks. Those who took the drug reported improvements in pain management, compared to those who didn’t take it.
Preliminary data also showed improvement in other IBS symptoms, including bloating and diarrhea. (Pfizer provided funds, medication, and placebo pills, but had no direct involvement in the study's design or implementation.)
Dr. Saito-Loftus cautions that, because the study was so small, the results are not definitive. She also says that—as with any drug—there would be pros and cons to consider if pregabalin were shown to be an effective IBS treatment.
“Neurological side effects such as sleepiness and feeling funny or dizzy are known side effects of pregabalin,” she says. This isn’t surprising, she adds, since the drug is known to target nerve cells.
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Dr. Saito-Loftus presented her research this week at the annual meeting of the American College of Gastroenterology in Las Vegas and it has not yet been published in a peer-reviewed medical journal, a key step for confirming new results. She says she doesn’t have set plans to do a larger study, but will be reaching out to Pfizer to gauge the company's interest.
At another annual meeting of gastroenterologists held this week—UEG Week in Vienna, Austria—researchers presented other research that may also one day help IBS patients better manage their symptoms. Their study was on a dietary treatment.
A low-FODMAP diet—which involves restricting carbohydrates such as wheat, barley, onions, legumes, and many fruits—has been shown to relieve IBS symptoms in about half of patients who try it. But there is currently know way to know who will respond and who won’t.
Now, researchers from the University of Gothenburg in Sweden say that fecal samples of patients who are helped by a low-FODMAP diet have a different bacterial composition than samples of those who aren’t. Testing people, they say, could potentially predict who will benefit.
"Being able to predict if a patient is unlikely to respond to a low-FODMAP diet means that other therapies could be discussed earlier,” said lead investigator and doctoral student Sean Bennet in a press release, “and these patients could be spared a demanding diet that might have no effect on, or even worsen, their symptoms."